Search tips
Search criteria 


Logo of jcmPermissionsJournals.ASM.orgJournalJCM ArticleJournal InfoAuthorsReviewers
J Clin Microbiol. 1983 September; 18(3): 512–520.
PMCID: PMC270845

Laboratory investigation of hemorrhagic colitis outbreaks associated with a rare Escherichia coli serotype.


Two outbreaks of hemorrhagic colitis, a newly recognized syndrome characterized by bloody diarrhea, severe abdominal pain, and little or no fever, occurred in 1982. No previously recognized pathogens were recovered from stool specimens from persons in either outbreak. However, a rare E. coli serotype, O157:H7, was isolated from 9 of 20 cases and from no controls. It was also recovered from a meat patty from the implicated lot eaten by persons in one outbreak. No recovery of this organism was made from stools collected 7 or more days after onset of illness; whereas 9 of 12 culture-positive stools had been collected within 4 days of onset of illness. The isolate was not invasive or toxigenic by standard tests, and all strains has a unique biotype. Plasmid profile analysis indicates that all outbreak-associated E. coli O157:H7 isolates are closely related. These results suggest that E. coli O157:H7 was the causative agent of illness in the two outbreaks.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.3M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Click on the image to see a larger version.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Birnboim HC, Doly J. A rapid alkaline extraction procedure for screening recombinant plasmid DNA. Nucleic Acids Res. 1979 Nov 24;7(6):1513–1523. [PMC free article] [PubMed]
  • Blaser MJ, Berkowitz ID, LaForce FM, Cravens J, Reller LB, Wang WL. Campylobacter enteritis: clinical and epidemiologic features. Ann Intern Med. 1979 Aug;91(2):179–185. [PubMed]
  • Dean AG, Ching YC, Williams RG, Harden LB. Test for Escherichia coli enterotoxin using infant mice: application in a study of diarrhea in children in Honolulu. J Infect Dis. 1972 Apr;125(4):407–411. [PubMed]
  • Evans DG, Evans DJ., Jr New surface-associated heat-labile colonization factor antigen (CFA/II) produced by enterotoxigenic Escherichia coli of serogroups O6 and O8. Infect Immun. 1978 Aug;21(2):638–647. [PMC free article] [PubMed]
  • Farmer JJ, 3rd, Potter ME, Riley LW, Barrett TJ, Blake PA, Bopp CA, Cohen ML, Kaufmann A, Morris GK, Remis RS, et al. Animal models to study Escherichia coli O157:H7 isolated from patients with haemorrhagic colitis. Lancet. 1983 Mar 26;1(8326 Pt 1):702–703. [PubMed]
  • Harris JR, Wachsmuth IK, Davis BR, Cohen ML. High-molecular-weight plasmid correlates with Escherichia coli enteroinvasiveness. Infect Immun. 1982 Sep;37(3):1295–1298. [PMC free article] [PubMed]
  • Hickman FW, Farmer JJ., 3rd Salmonella typhi: identification, antibiograms, serology, and bacteriophage typing. Am J Med Technol. 1978 Dec;44(12):1149–1159. [PubMed]
  • Jarvis W, Nunez-Montiel O, Thompson F, Dowell V, Towns M, Morris G, Hill E. Comparison of bacterial isolation, cytotoxicity assay, and counterimmunoelectrophoresis for the detection of Clostridium difficile and its toxin. J Infect Dis. 1983 Apr;147(4):778–778. [PubMed]
  • Labrec EH, Schneider H, Magnani TJ, Formal SB. EPITHELIAL CELL PENETRATION AS AN ESSENTIAL STEP IN THE PATHOGENESIS OF BACILLARY DYSENTERY. J Bacteriol. 1964 Nov;88(5):1503–1518. [PMC free article] [PubMed]
  • Levine MM, Bergquist EJ, Nalin DR, Waterman DH, Hornick RB, Young CR, Sotman S. Escherichia coli strains that cause diarrhoea but do not produce heat-labile or heat-stable enterotoxins and are non-invasive. Lancet. 1978 May 27;1(8074):1119–1122. [PubMed]
  • Macrina FL, Kopecko DJ, Jones KR, Ayers DJ, McCowen SM. A multiple plasmid-containing Escherichia coli strain: convenient source of size reference plasmid molecules. Plasmid. 1978 Jun;1(3):417–420. [PubMed]
  • Malathi P, Preiser H, Fairclough P, Mallett P, Crane RK. A rapid method for the isolation of kidney brush border membranes. Biochim Biophys Acta. 1979 Jun 13;554(1):259–263. [PubMed]
  • Meyers JA, Sanchez D, Elwell LP, Falkow S. Simple agarose gel electrophoretic method for the identification and characterization of plasmid deoxyribonucleic acid. J Bacteriol. 1976 Sep;127(3):1529–1537. [PMC free article] [PubMed]
  • Morris GK, Merson MH, Sack DA, Wells JG, Martin WT, Dewitt WE, Feeley JC, Sack RB, Bessudo DM. Laboratory investigation of diarrhea in travelers to Mexico: evaluation of methods for detecting enterotoxigenic Echerichia coli. J Clin Microbiol. 1976 May;3(5):486–495. [PMC free article] [PubMed]
  • Moseley SL, Echeverria P, Seriwatana J, Tirapat C, Chaicumpa W, Sakuldaipeara T, Falkow S. Identification of enterotoxigenic Escherichia coli by colony hybridization using three enterotoxin gene probes. J Infect Dis. 1982 Jun;145(6):863–869. [PubMed]
  • Riley LW, Remis RS, Helgerson SD, McGee HB, Wells JG, Davis BR, Hebert RJ, Olcott ES, Johnson LM, Hargrett NT, et al. Hemorrhagic colitis associated with a rare Escherichia coli serotype. N Engl J Med. 1983 Mar 24;308(12):681–685. [PubMed]
  • Sack DA, Sack RB. Test for enterotoxigenic Escherichia coli using Y-1 adrenal cells in miniculture. Infect Immun. 1975 Feb;11(2):334–336. [PMC free article] [PubMed]
  • Sakurai Y, Tsuchiya H, Ikegami F, Funatomi T, Takasu S, Uchikoshi T. Acute right-sided hemorrhagic colitis associated with oral administration of ampicillin. Dig Dis Sci. 1979 Dec;24(12):910–915. [PubMed]
  • Schroeder SA, Caldwell JR, Vernon TM, White PC, Granger SI, Bennett JV. A waterborne outbreak of gastroenteritis in adults associated with Escherichia coli. Lancet. 1968 Apr 6;1(7545):737–740. [PubMed]
  • SERENY B. Experimental shigella keratoconjunctivitis; a preliminary report. Acta Microbiol Acad Sci Hung. 1955;2(3):293–296. [PubMed]
  • Skirrow MB. Campylobacter enteritis: a "new" disease. Br Med J. 1977 Jul 2;2(6078):9–11. [PMC free article] [PubMed]
  • Toffler RB, Pingoud EG, Burrell MI. Acute colitis related to penicillin and penicillin derivatives. Lancet. 1978 Sep 30;2(8092 Pt 1):707–709. [PubMed]
  • Totani T. [Acute hemorrhagic enteritis with Klebsiella oxytoca]. Nihon Rinsho. 1978 May;Suppl:1308–1309. [PubMed]
  • Yolken RH, Greenberg HB, Merson MH, Sack RB, Kapikian AZ. Enzyme-linked immunosorbent assay for detection of Escherichia coli heat-labile enterotoxin. J Clin Microbiol. 1977 Nov;6(5):439–444. [PMC free article] [PubMed]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)